Abstract
Purpose :
Glaucoma, one of the leading causes of blindness, results in gradual deterioration of peripheral field loss and significant disturbance of patients’ physical activities, including gait performance. Our study aimed to examine the differences in gait behaviors among older individuals with glaucoma from their healthy peers while negotiating obstacle-crossing with and without dual tasks.
Methods :
Ten patients with moderate to severe bilateral glaucoma and 10 age-matched healthy subjects were recruited. Gait patterns were recorded and analyzed using a motion capture system (Vicon Nexus 2.9.1). Participants were asked to walk at self-pace along a 7m walk path and cross an obstacle using their dominant leg while performing a visual task. Three obstacle heights (0, 5, and 15 cm) combined with two visual tasks (fixation and visual searching) were randomly assigned to a given trial. Outcome measures, including head movement, stride length (SL), percentage of preferred walking speed (PPWS), swing phase (SP), and toe clearance of the leading limb (LTC), were analyzed for the gait cycle during obstacle crossing.
Results :
The height of the obstacles showed a significant impact on the gait pattern, leading to greater head movement, decreased PPWS, and longer SP when negotiating a higher obstacle (p≤0.001). However, the majority of gait parameters showed no significant differences between the two groups, except that glaucoma patients stepped significantly wider while crossing the obstacle (p = 0.05). Surprisingly, the visual task did not significantly influence participants’ walking behavior. However, an interaction effect of group and visual task was observed, with the control group crossing the obstacle faster during the visual searching task (p<0.001).
Conclusions :
Based on our preliminary findings, while negotiating higher obstacles, participants with glaucoma made significantly more head movements, reduced crossing speed, and longer SP. However, the impact of the dual tasks during obstacle negotiation was less than anticipated. Conducting the visual search immediately after obstacle crossing might limit the impact compared to conducting the visual search during obstacle crossing. Furthermore, the lack of significant differences in the gait between the two groups suggests that visual field loss in the glaucoma group might not be strong enough to cause a substantial detrimental impact.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.